ACA Has Accelerated Health Reform in Calif., but Barriers Remain
Health care reform that already was underway in California has been accelerated by the Affordable Care Act, but challenges still remain, the CHCF Center for Health Reporting/KQED's "State of Health" reports.
CHCF publishes California Healthline.
California was one of the first states to create its own health insurance exchange and expand Medi-Cal under the ACA. Medi-Cal is California's Medicaid program.
About 3.6 million state residents enrolled in health coverage this year, decreasing California's uninsured rate from 17% to 11%, according to the Center for Health Reporting/"State of Health."
Details of Challenges
However, despite increased access to chronic disease care under the ACA, Californians still struggle with access to specialists and certain prescription drugs, according to the Center for Health Reporting/"State of Health."
Garry Maisel -- CEO of Western Health Advantage, which is offering health plans through Covered California -- added that the state insurance exchange, as well as individual insurers, have not provided adequate provider lists to consumers for exchange plans.
California Health and Human Services Agency Secretary Diana Dooley said the state is working to fix such issues amid the exchange's second open enrollment period (Schoch/Whaley, "State of Health," CHCF Center for Health Reporting/ KQED, 12/7).
In an interview with the Center for Health Reporting, Dooley said the state "exceeded our most optimistic projections of enrollment -- at Covered California and with Medi-Cal."
Dooley said the state is "in the position of dancing as fast as we can to catch up and accommodate" the new enrollees, adding, "[T]here is going to be a pretty significant period of adjustment."
When asked about how low reimbursement rates could result in fewer Medi-Cal providers, she said that "it may be that fewer [Medi-Cal beneficiaries] need to go to the doctor," adding, "If we're paying our providers on a capitated basis, and our plans are managing their care, we are getting value."
Meanwhile, Dooley said the state has set a goal to become "the healthiest state in the nation by 2022" by "focusing on health and outcomes and not procedures and unit costs of care" (Schoch, CHCF Center for Health Reporting/Fresno Bee, 12/6).This is part of the California Healthline Daily Edition, a summary of health policy coverage from major news organizations. Sign up for an email subscription.